Kyu Yean Kim1, Hye Lim Park2, Hye Seon Kang1, Hwa Young Lee1, Ie Ryung Yoo3, Sang Haak Lee1, Chang Dong Yeo4. 1. Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 2. Division of Nuclear Medicine, Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 3. Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 4. Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; brainyeo@catholic.ac.kr.
Abstract
BACKGROUND/AIM: Preoperative fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET-CT) is a non-invasive and useful diagnostic tool to evaluate mediastinal lymph node (LN) metastasis in lung cancer. However, there are often false-positive LN cases in FDG PET-CT. This study aimed to explore the clinical characteristics and outcome of pathologic N0 non-small cell lung cancer patients with false-positive mediastinal LN on FDG PET-CT. PATIENTS AND METHODS: We enrolled 147 patients who underwent preoperative FDG PET-CT scan and mediastinal LN dissection. These patients were re-evaluated for post-operative pathologic nodal metastasis and divided into a false-positive group and a group of others. RESULTS: Among 40 patients diagnosed with clinical N1-3 on FDG PET-CT, 19 (47.5%) patients were pathologic N0, meaning false-positive LN by PET-CT. Preoperative absolute platelet count and platelet-lymphocyte ratio were significantly higher in patients with pathologic N0. The presence of lymphatic invasion was significantly lower in patients with pathologic N0 than in the group of others. Recurrence-free survival was significantly shorter in patients with false positive LN than in patients with true positive LN or true negative LN at the same pathologic stage. CONCLUSION: Higher absolute platelet count and PLR, lower proportion of lymphatic invasion and shorter recurrence-free survival were associated with false positive mediastinal LN on preoperative FDG PET-CT. Copyright
BACKGROUND/AIM: Preoperative fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET-CT) is a non-invasive and useful diagnostic tool to evaluate mediastinal lymph node (LN) metastasis in lung cancer. However, there are often false-positive LN cases in FDG PET-CT. This study aimed to explore the clinical characteristics and outcome of pathologic N0 non-small cell lung cancerpatients with false-positive mediastinal LN on FDG PET-CT. PATIENTS AND METHODS: We enrolled 147 patients who underwent preoperative FDG PET-CT scan and mediastinal LN dissection. These patients were re-evaluated for post-operative pathologic nodal metastasis and divided into a false-positive group and a group of others. RESULTS: Among 40 patients diagnosed with clinical N1-3 on FDG PET-CT, 19 (47.5%) patients were pathologic N0, meaning false-positive LN by PET-CT. Preoperative absolute platelet count and platelet-lymphocyte ratio were significantly higher in patients with pathologic N0. The presence of lymphatic invasion was significantly lower in patients with pathologic N0 than in the group of others. Recurrence-free survival was significantly shorter in patients with false positive LN than in patients with true positive LN or true negative LN at the same pathologic stage. CONCLUSION: Higher absolute platelet count and PLR, lower proportion of lymphatic invasion and shorter recurrence-free survival were associated with false positive mediastinal LN on preoperative FDG PET-CT. Copyright
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